title: Nutritional status is superior to the ECOG performance status in predicting the dose-intensity of the GEMOX chemotherapy regimen in patients with advanced cancer.
abstract: The increasing number of unfit patients calls for better risk assessment prior to initiating anti-tumor treatment. This is a major concern in the prevention and reduction of treatment-related complications. The aim of our study was to evaluate the nutritional status for the risk assessment of patients qualifying to receive the gemcitabine and oxaliplatin (GEMOX) regimen. This single-center, retrospective study examined baseline clinical and biological characteristics in a cohort of 165 unselected, consecutive cancer patients receiving GEMOX. Malnutrition was defined as either body mass index (BMI) <18.5 kg/m(2), body weight loss >10% over 3 mo, or albuminemia <35 g/L. A total of 165 patients (median age 61 yr, PS 0-1: 71%) were studied. Malnutrition was seen in 43% of PS 0-1 patients, vs. 60% of PS 2 and 66% of PS 3 patients (P > 0.05). Median relative dose-intensity was 0.90 (0.17-1.04). GEMOX dose-intensity correlated negatively with loss of baseline weight (r = -0.24, P < 0.02). In patients who did not complete more than 2 cycles of chemotherapy, median PS (P < 0.01), mean C-reactive protein (CRP; P < 0.01), and mean albuminemia (P < 0.05) were, respectively, significantly higher, higher, and lower. Malnutrition is associated with a high risk of early discontinuance of treatment. Systematic basal evaluation of the nutritional status, including albuminemia and BMI, is recommended.
authors.affiliation: a Department of Medical Oncology, Cochin Teaching Hospital, Assistance Publique-Hôpitaux de Paris , Paris Descartes University , France.
authors.forename: Anatole
authors.initials: A
authors.lastname: Cessot
authors.forename: Romain
authors.initials: R
authors.lastname: Coriat
authors.forename: Oliver
authors.initials: O
authors.lastname: Mir
authors.forename: Pascaline
authors.initials: P
authors.lastname: Boudou-Rouquette
authors.forename: Julie
authors.initials: J
authors.lastname: Giroux
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Durand
authors.forename: Jérôme
authors.initials: J
authors.lastname: Alexandre
authors.forename: Francois
authors.initials: F
authors.lastname: Goldwasser
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology*; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D009752:Nutritional Status; D009944:Organoplatinum Compounds / Q000494:pharmacology; D012189:Retrospective Studies; D018570:Risk Assessment; D015431:Weight Loss
chemical_list: D009944:Organoplatinum Compounds; D003841:Deoxycytidine; D002097:C-Reactive Protein